tbuckley/cabot-search huggingface dataset:
Unsupervised ECG Analysis: A Review
Authors: Kasra Nezamabadi, Neda Sardaripour, Benyamin Haghi, Mohamad Forouzanfar
Journal: IEEE Reviews in Biomedical Engineering (2022)

Electrocardiography is the gold standard technique for detecting abnormal heart conditions. Automatic detection of electrocardiogram (ECG) abnormalities helps clinicians analyze the large amount of data produced daily by cardiac monitors. As thenumber of abnormal ECG samples with cardiologist-supplied labels required to train supervised machine learning models is limited, there is a growing need for unsupervised learning methods for ECG analysis. Unsupervised learning aims to partition ECG samples into distinct abnormality classes without cardiologist-supplied labels–a process referred to as ECG clustering. In addition to abnormality detection, ECG clustering has recently discovered inter and intra-individual patterns that reveal valuable information about the whole body and mind, such as emotions, mental disorders, and metabolic levels. ECG clustering can also resolve specific challenges facing supervised learning systems, such as the imbalanced data problem, and can enhance biometric systems. While several reviews exist on supervised ECG systems, a comprehensive review of unsupervised ECG analysis techniques is still lacking. This study reviews ECG clustering techniques developed mainly in the last decade. The focus will be on recent machine learning and deep learning algorithms and their practical applications. We critically review and compare these techniques, discuss their applications and limitations, and provide future research directions. This review provides further insights into ECG clustering and presents the necessary information required to adopt the appropriate algorithm for a specific application.
Systemic Chemotherapies Retain Antitumor Activity in Desmoid Tumors Independent of Specific Mutations in<i>CTNNB1</i>or<i>APC</i>: A Multi-institutional Retrospective Study
Authors: Michael J. Nathenson, Junxiao Hu, Ravin Ratan, Neeta Somaiah, Robert Hsu, Peter J. DeMaria, Heath W. Catoe, Angela Pang, Ty K. Subhawong, Behrang Amini, Kevin Sweet, Katharina Feister, Karan Malik, Jyothi Jagannathan, Marta Braschi-Amirfarzan, Jamie Sheren, Yupanqui Caldas, Cristiam Moreno Tellez, Andrew E. Rosenberg, Alexander J. Lazar, Robert G. Maki, Pasquale Benedetto, Jonathan Cohen, Jonathan C. Trent, Vinod Ravi, Shreyaskumar Patel, Breelyn A. Wilky
Journal: Clinical Cancer Research (2022)

Determine whether specific CTNNB1 or APC mutations in patients with desmoid tumor were associated with differences in clinical responses to systemic treatments.We established a multi-institutional dataset of previously treated patients with desmoid tumor across four U.S. sarcoma centers, including demographic and clinicopathologic characteristics, treatment regimens, and clinical and radiographic responses. CTNNB1 or APC mutation status was determined from prior pathology records, or archival tissue was requested and analyzed by Sanger sequencing and/or next-generation sequencing. Evaluable patients with mutation results were analyzed to determine clinical progression-free survival (cPFS), RECIST 1.1 PFS (rPFS), time to next treatment (TTNT), and overall survival (OS). Kaplan-Meier analysis and Cox proportional hazards regression were performed to identify differences in cPFS, rPFS, TTNT, and OS by mutation subtype, desmoid tumor location, and treatment regimen.A total of 259 evaluable patients were analyzed for at least one of the survival outcomes, with 177 patients having mutation data. First- and second-line cPFS, rPFS, and TTNT were not significantly affected by mutation subtype; however, APC-mutant desmoid tumors demonstrated nonstatistically significant inferior outcomes. Extremity/trunk desmoid tumor location and treatment with doxorubicin-based, methotrexate/vinca alkaloids and sorafenib regimens were associated with better clinical outcomes compared with surgery or "other" therapies, including estrogen-receptor blockade and imatinib. OS was significantly worse with APC or CTNNB1 negative/other mutations.Mutation subtype did not affect responses to specific systemic therapies. APC mutations and nonextremity desmoid tumor locations remain prognostic for worse outcomes, and earlier initiation of systemic therapy for these higher-risk desmoid tumors should be prospectively evaluated. See related commentary by Greene and Van Tine, p. 3911.
Case 23-2022: A 49-Year-Old Man with Hypoglycemia
Authors: Amy W. Baughman, Nancy J. Wei, Peter F. Hahn, Brenna W. Casey, M. Lisa Zhang
Journal: New England Journal of Medicine (2022)

A 49-year-old man with a family history of diabetes was evaluated because of hypoglycemia. Two hours earlier, he had been found on the floor, obtunded and making nonpurposeful movements. A diagnostic test was performed.
Germline Mutations in <i>CIDEB</i> and Protection against Liver Disease
Authors: Niek Verweij, Mary E. Haas, Jonas B. Nielsen, Olukayode A. Sosina, Minhee Kim, Parsa Akbari, Tanima De, George Hindy, Jonas Bovijn, Trikaldarshi Persaud, Lawrence Miloscio, Mary Germino, Lampros Panagis, Kyoko Watanabe, Joelle Mbatchou, Marcus Jones, Michelle LeBlanc, Suganthi Balasubramanian, Craig Lammert, Sofia Enhörning, Olle Melander, David J. Carey, Christopher D. Still, Tooraj Mirshahi, Daniel J. Rader, Prodromos Parasoglou, Johnathon R. Walls, John D. Overton, Jeffrey G. Reid, Aris Economides, Michael N. Cantor, Brian Zambrowicz, Andrew J. Murphy, Goncalo R. Abecasis, Manuel A.R. Ferreira, Eriks Smagris, Viktoria Gusarova, Mark Sleeman, George D. Yancopoulos, Jonathan Marchini, Hyun M. Kang, Katia Karalis, Alan R. Shuldiner, Giusy Della Gatta, Adam E. Locke, Aris Baras, Luca A. Lotta
Journal: New England Journal of Medicine (2022)

Exome sequencing in hundreds of thousands of persons may enable the identification of rare protein-coding genetic variants associated with protection from human diseases like liver cirrhosis, providing a strategy for the discovery of new therapeutic targets.
Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults
Authors: Meryl S. LeBoff, Sharon H. Chou, Kristin A. Ratliff, Nancy R. Cook, Bharti Khurana, Eunjung Kim, Peggy M. Cawthon, Douglas C. Bauer, Dennis Black, J. Chris Gallagher, I-Min Lee, Julie E. Buring, JoAnn E. Manson
Journal: New England Journal of Medicine (2022)

Vitamin D supplements are widely recommended for bone health in the general population, but data on whether they prevent fractures have been inconsistent.
VITAL Findings — A Decisive Verdict on Vitamin D Supplementation
Authors: Steven R. Cummings, Clifford Rosen
Journal: New England Journal of Medicine (2022)

An estimated one third or more of U.S. adults 60 years of age or older take vitamin D supplements, not including those who take multivitamins or other compounds containing vitamin D.1 Yet controversy continues about its overall benefits. In this issue of the Journal, LeBoff and colleagues2 report findings from an ancillary study of the Vitamin D and Omega-3 Trial (VITAL),3 which extend the results of that trial; taken together, VITAL and this ancillary study show that vitamin supplements do not have important health benefits in the general population of older adults, even in those with low 25-hydroxyvitamin D levels. . . .
Fundamentals of Health Law — A New Perspective Series
Authors: Erin C. Fuse Brown, Aaron S. Kesselheim, Debra Malina, Genevra Pittman, Stephen Morrissey
Journal: New England Journal of Medicine (2022)

The editors announce a new series of Perspective articles focusing on the multifaceted relationship between U.S. medicine and the law and on the myriad roles health law plays in patients' lives and in the delivery of care.
The History of Health Law in the United States
Authors: Erin C. Fuse Brown, Aaron S. Kesselheim
Journal: New England Journal of Medicine (2022)

Interview with Prof. Erin Fuse Brown on the history of health law in the United States and potential future directions for the field. (13:04)Download Health law shapes the landscape of health care delivery in powerful ways. The history of health law can be broken into four eras, each with its own prevailing ethos.
Trial of Anti-BDCA2 Antibody Litifilimab for Cutaneous Lupus Erythematosus
Authors: Victoria P. Werth, Richard A. Furie, Juanita Romero-Diaz, Sandra Navarra, Kenneth Kalunian, Ronald F. van Vollenhoven, Filippa Nyberg, Benjamin H. Kaffenberger, Saira Z. Sheikh, Goran Radunovic, Xiaobi Huang, George Clark, Hua Carroll, Himanshu Naik, Francois Gaudreault, Adam Meyers, Catherine Barbey, Cristina Musselli, Nathalie Franchimont
Journal: New England Journal of Medicine (2022)

Blood dendritic cell antigen 2 (BDCA2) is a receptor that is exclusively expressed on plasmacytoid dendritic cells, which are implicated in the pathogenesis of lupus erythematosus. Whether treatment with litifilimab, a humanized monoclonal antibody against BDCA2, would be efficacious in reducing disease activity in patients with cutaneous lupus erythematosus has not been extensively studied.In this phase 2 trial, we randomly assigned adults with histologically confirmed cutaneous lupus erythematosus with or without systemic manifestations in a 1:1:1:1 ratio to receive subcutaneous litifilimab (at a dose of 50, 150, or 450 mg) or placebo at weeks 0, 2, 4, 8, and 12. We used a dose-response model to assess whether there was a response across the four groups on the basis of the primary end point, which was the percent change from baseline to 16 weeks in the Cutaneous Lupus Erythematosus Disease Area and Severity Index-Activity score (CLASI-A; scores range from 0 to 70, with higher scores indicating more widespread or severe skin involvement). Safety was also assessed.A total of 132 participants were enrolled; 26 were assigned to the 50-mg litifilimab group, 25 to the 150-mg litifilimab group, 48 to the 450-mg litifilimab group, and 33 to the placebo group. Mean CLASI-A scores for the groups at baseline were 15.2, 18.4, 16.5, and 16.5, respectively. The difference from placebo in the change from baseline in CLASI-A score at week 16 was -24.3 percentage points (95% confidence interval [CI] -43.7 to -4.9) in the 50-mg litifilimab group, -33.4 percentage points (95% CI, -52.7 to -14.1) in the 150-mg group, and -28.0 percentage points (95% CI, -44.6 to -11.4) in the 450-mg group. The least squares mean changes were used in the primary analysis of a best-fitting dose-response model across the three drug-dose levels and placebo, which showed a significant effect. Most of the secondary end points did not support the results of the primary analysis. Litifilimab was associated with three cases each of hypersensitivity and oral herpes infection and one case of herpes zoster infection. One case of herpes zoster meningitis occurred 4 months after the participant received the last dose of litifilimab.In a phase 2 trial involving participants with cutaneous lupus erythematosus, treatment with litifilimab was superior to placebo with regard to a measure of skin disease activity over a period of 16 weeks. Larger and longer trials are needed to determine the effect and safety of litifilimab for the treatment of cutaneous lupus erythematosus. (Funded by Biogen; LILAC ClinicalTrials.gov number, NCT02847598.).
Perspectives on Hyperthermic Intraperitoneal Chemotherapy for Advanced Ovarian Cancer—Reply
Authors: Myong Cheol Lim, Boram Park, Sang-Yoon Park
Journal: JAMA Surgery (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Quantifying Deviations of Brain Structure and Function in Major Depressive Disorder Across Neuroimaging Modalities
Authors: Nils R. Winter, Ramona Leenings, Jan Ernsting, Kelvin Sarink, Lukas Fisch, Daniel Emden, Julian Blanke, Janik Goltermann, Nils Opel, Carlotta Barkhau, Susanne Meinert, Katharina Dohm, Jonathan Repple, Marco Mauritz, Marius Gruber, Elisabeth J. Leehr, Dominik Grotegerd, Ronny Redlich, Andreas Jansen, Igor Nenadic, Markus M. Nöthen, Andreas Forstner, Marcella Rietschel, Joachim Groß, Jochen Bauer, Walter Heindel, Till Andlauer, Simon B. Eickhoff, Tilo Kircher, Udo Dannlowski, Tim Hahn
Journal: JAMA Psychiatry (2022)

Identifying neurobiological differences between patients with major depressive disorder (MDD) and healthy individuals has been a mainstay of clinical neuroscience for decades. However, recent meta-analyses have raised concerns regarding the replicability and clinical relevance of brain alterations in depression.
Melanoma Overdiagnosis Is Not the Key Problem—Reply
Authors: Adewole S. Adamson, Elizabeth A. Suarez, H. Gilbert Welch
Journal: JAMA Dermatology (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Surgical Experience Disparity Between Male and Female Surgeons in Japan
Authors: Emiko Kono, Urara Isozumi, Sachiyo Nomura, Kae Okoshi, Hiroyuki Yamamoto, Hiroaki Miyata, Itaru Yasufuku, Hiromichi Maeda, Junichi Sakamoto, Kazuhisa Uchiyama, Yoshihiro Kakeji, Kazuhiro Yoshida, Yuko Kitagawa
Journal: JAMA Surgery (2022)

<h3>Importance</h3> Women are vastly underrepresented in surgical leadership and management in Japan. The lack of equal opportunities for surgical training is speculated to be the main reason for this disparity; however, this hypothesis has not been investigated thus far. <h3>Objective</h3> To examine gender disparity in the number of surgical experiences among Japanese surgeons. <h3>Design, Setting, and Participants</h3> This retrospective, multicenter cross-sectional study used data from the National Clinical Database, which contains more than 95% of all surgical procedures in Japan. Participants included male and female gastroenterological surgeons who performed appendectomy, cholecystectomy, right hemicolectomy, distal gastrectomy, low anterior resection, and pancreaticoduodenectomy between January 1, 2013, and December 31, 2017. <h3>Exposures</h3> Differences in the number of surgical experiences between male and female surgeons. <h3>Main Outcomes and Measures</h3> The primary outcomes were the total number of operations and number of operations per surgeon by gender and years of experience. Data were analyzed from March 18 to August 31, 2021. <h3>Results</h3> Of 1 147 068 total operations, 83 354 (7.27%) were performed by female surgeons and 1 063 714 (92.73%) by male surgeons. Among the 6 operative procedures, the percentage of operations performed by female surgeons were the highest for appendectomy (n = 20 648 [9.83%]) and cholecystectomy (n = 41 271 [7.89%]) and lowest for low anterior resection (n = 4507 [4.57%]) and pancreaticoduodenectomy (n = 1329 [2.64%]). Regarding the number of operations per surgeon, female surgeons had fewer surgical experiences for all 6 types of operations in all years after registration, except for appendectomy and cholecystectomy in the first 2 years after medical registration. The largest gender disparity for each surgical procedure was 3.17 times more procedures for male vs female surgeons for appendectomy (at 15 years after medical registration), 4.93 times for cholecystectomy (at 30-39 years), 3.65 times for right hemicolectomy (at 30-39 years), 3.02 times for distal gastrectomy (at 27-29 years), 6.75 times for low anterior resection (at 27-29 years), and 22.2 times for pancreaticoduodenectomy (at 30-39 years). <h3>Conclusions and Relevance</h3> This cross-sectional study found that female surgeons had less surgical experience than male surgeons in Japan, and this gap tended to widen with an increase in years of experience, especially for medium- and high-difficulty operations. Gender disparity in surgical experience needs to be eliminated, so that female surgeons can advance to leadership positions.
Association of Everyday Discrimination With Depressive Symptoms and Suicidal Ideation During the COVID-19 Pandemic in the All of Us Research Program
Authors: Younga H. Lee, Zhaowen Liu, Daniel Fatori, Joshua R. Bauermeister, Rebecca A. Luh, Cheryl R. Clark, Sarah Bauermeister, André R. Brunoni, Jordan W. Smoller
Journal: JAMA Psychiatry (2022)

The COVID-19 pandemic has coincided with an increase in depressive symptoms as well as a growing awareness of health inequities and structural racism in the United States.
Clinicophotobiological Characterization of Photoaggravated Atopic Dermatitis
Authors: Kirsty J. Rutter, Mark D. Farrar, Elizabeth J. Marjanovic, Lesley E. Rhodes
Journal: JAMA Dermatology (2022)

Importance Photoaggravated atopic dermatitis (PAD) is estimated to affect 1.4% to 16% of patients with AD but remains poorly characterized with limited published data. Objective To provide detailed clinical and photobiological characterization of PAD. Design, Setting, and Participants This case series study used cross-sectional data collected from 120 consecutive patients diagnosed with PAD from January 2015 to October 2019 at a tertiary center referral unit for photobiology. Main Outcomes and Measures Routinely collected standardized clinical and photobiological data were analyzed using descriptive statistics, and regression analysis explored associations between demographic and clinical data. Results Of 869 patients who underwent photoinvestigation, 120 (14%) were diagnosed with PAD (69 female [58%]; median age, 45 [IQR, 31-61] years; range, 5-83 years; skin phototypes [SPTs] I-VI). Of these patients, 104 (87%) were adults. All patients had a history of AD, and most (62 of 104 [60%]) presented with sunlight-provoked or photodistributed eczema; median age at photosensitivity onset was 37 years (range, 1-72 years). Past-year Dermatology Life Quality Index score was greater than 10 for 80 of 103 adults (78%), and 82 of 119 (69%) had vitamin D (25-hydroxyvitamin D) level insufficiency or deficiency (&amp;lt;20 ng/mL; to convert ng/mL to nmol/L, multiply by 2.496). Broadband UV radiation provocation test results were positive for 112 patients (93%). In 28 patients (23%) with abnormal monochromator phototest findings, sensitivity occurred to UV-A, UV-B, and/or visible light, and UV-A of 350 ± 10 nm was the most prevalent wavelength. Photopatch test reactions were positive for 18 patients (15%). Patients with SPTs V to VI (31 [26%]) vs SPTs I to IV (89 [74%]) were younger at photosensitivity onset (median age, 24 years [IQR, 15-37 years] vs 40 years [IQR, 25-55 years]; P = .003), were more likely to be female (23 [74%] vs 46 [52%]; P = .03), and had a lower vitamin D status and a higher frequency of abnormal monochromator phototest findings. Conclusions and Relevance In this case series study, PAD affected patients with different ages and SPTs and was associated with substantially impaired quality of life. The findings suggest that confirming PAD through phototesting may provide better personalized care for patients through identification of provoking wavelengths, relevant photocontact allergies, and appropriate photoprotection advice.
Neuropsychoimaging Measures as Alternatives to Drug Use Outcomes in Clinical Trials for Addiction
Authors: Rita Z. Goldstein
Journal: JAMA Psychiatry (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
Association of Continuous Glucose Monitoring Use and Hemoglobin A<sub>1c</sub> Levels Across the Lifespan Among Individuals With Type 1 Diabetes in the US
Authors: Joshua M. Weinstein, Anna R. Kahkoska
Journal: JAMA Network Open (2022)

This cross-sectional study investigates age, probability of continuous glucose monitoring use, and their association with glycemic control across the lifespan among US individuals with type 1 diabetes.